Population aging is a problem confronting many countries around the world and poses grim challenges to the conventional healthcare model.The measure proposal by WHO,the establishment of age-friendly community-based primary healthcare centers and medical institutions,is both practical and feasible,based on which many countries have formulated implementation frameworks.In China,it is of paramount importance to promote the development of age-friendly hospitals,especially geriatric specialty hospitals,rehabilitation hospitals and nursing homes,in the healthcare sector.Integrated care services offered by age-friendly hospitals can help reduce complications,improve care quality and patient satisfaction,and cut costs,benefiting elderly patients and their families and ultimately moving the healthcare reform forward.

Objective To investigate the effects of posterior focus on the voice quality of hearing-impaired children.Methods A total of 15 cases of 3~6 years old hearing-impaired children with posterior focus and 20 cases of 3~6 years old without oral resonance disorders were included in this study.Fundamental frequency (F0), frequency standard deviation (F0SD), fundamental frequency perturbation (jitter), amplitude perturbation (shimmer) and normalized noise energy (NNE) on each group of children of /(ae)/ were extracted and analyzed by Dr.Voice.Results Hearing-impaired children with posterior focus problems mainly showed the voice disorder of the hyperthyroidism type.The abnormal rate of shimmer values was the highest of hearing-impaired children with posterior focus, followed by F0, jitter and F0SD,and the minimum was NNE.The average value of the voice parameters was greater than hearing-impaired children without oral resonance disorders.The jitter and shimmer of children with posterior focus showed significant differences (P<0.05) compared to the hearing-impaired children without oral resonance disorders.Conclusion Children with posterior focus have a high rate of voice disorders and mainly change the voice jitter and shimmer.

Objective To compare the oral resonance differences between normal children and children with spastic cerebral palsy,and to explore the oral resonance characteristics of children with spastic cerebral palsy.Meth-ods A total of 15 cases of preschool children with spastic cerebral palsy and 25 cases of normal preschool children were included in this study.The first and second formants on each group of children of Chinese vowels/a/,/i/,/u/core,were extracted and analyzed by Dr speech software.Results There were no significant difference of/a/F1,/a/F2,/u/F1 between two groups (P>0.05);/i/F1 and/u/F2 had a significant difference (P<0.05);/i/F2 had a high degree of statistical significance (P<0.01).Conclusion Children with spastic cerebral palsy are prone to oral resonance while most oral resonance disorder of children with cerebral palsy is post focusing and mixed oral res-onance disorder;/i/F2 and/u/F2 can provide a meaningful reference for speech and oral resonance disorders evalua-tion of children with cerebral palsy.

Objective To establish a method for the determination of Alkaloid in cut crude drug of aconite root.Method Contents of aconitine,hypaconitine and mesaconitine incrude drug of aconite root were determined by LC-MS.It was carried out on Inertsil ODS-3 column(150 mm?4.6 mm,5 ?m),with acetonitrile-ammonium acetate buffer solution(60:40) as mobile phase,at a flow rate of 0.2 mL/min and temperature of 30 ℃.Result The method of determining Alkaloid content in crude drug of aconite root was established and 25 lots of crude drugs were determined.Conclusion The method was sensitive and specifical,can be used to control the quality of cut crude drug from aconite root.

Objective To discuss the value of percutaneous dilatational tracheotomy(PDT) for cardiosurgery in intensive care unit by comparing its outcomes with that of open tracheotomy(OT).MethodsA prospective study was conducted on 40 severe patients undergoing cardiosurgery.The patients were divided into PDT(treated from January 2002 to July 2003) and OT groups(treated from August 2003 to February 2008) with 20 cases in each.The operation time,length and heal time of the incision,blood loss,vital signs,and postoperative complications were compared between the two groups.ResultsThe operation time,length and heal time of the incision in the PDT group were significantly different from that in the OT group [(8.8?2.2) min vs(21.5?5.3) min,t=-9.897;(1.3?0.2) cm vs(3.4?0.5) cm,t=-17.440;and(3.9?0.9) d vs(5.9?1.2) d,t=-5.963;P=0.000].One patient in the PDT group(5%) had Ⅱ degree blood loss during the operation that was significantly less than those in the OT group(13 patients,65%,?2=15.824,P=0.000).The level of the vital signs change in the PDT group was significantly milder than those in the OT group [MAP: 1-5 mm Hg(median 2) vs 1-20 mm Hg(median 3.5),Z=-2.959,P=0.003;heart rate: 3-12 beats/min(median 5.5) vs 7-70 beats/min(median 10),Z=-3.956,P=0.000;SpO2: 0-4%(median 2%) vs 0-31%(median 3.5%),Z=-3.548,P=0.000].Furthermore,the rate of incisional leakage of sputum and overall rate of complications in the PDT group were significantly lower than those in the OT group.[1(5%) vs 8(40%),?2=5.161,P=0.023;and 1(5%) vs 12(60%),?2=13.789,P=0.000].ConclusionsPDT is a safe and minimally invasive technique with a high rate of success and low rate of complications.The method is easy to operate,and thus could be a good choice for severe patients after cardiovascular surgeries.

Objective To investigate the relationship of the lymphangiogenesis and lymphatic metastasis by observing the expression of proliferating cell nuclear antigen in the hamster tongue cancer development and analyzing the correlations of lymph vessel density (LVD), lymphatic vessel area (LVA) and malignance or lymphatic metastasis of tongue cancer cells. Methods Forty_two hamster tongue cancer models were induced by painting 1.5% 7,12-dimethylben(a) anthracene (DMBA) acetone solution after scratching, 7 models were sacrificed every two weeks. The pathological changes of tongue cancer were determined by the HE staining. The lymphatic hyperplasia was determined by PCNA and Desmoplakin(DP I +Ⅱ) Immunohistochemical double staining. The tumors and lymphatic endothelial cell proliferation index (proliferation index, PI), lymphatic vessel density (LVD) and lymphatic vessel area (LVA) were measured and statistically analyzed. Results The oncogenesis of tongue was divided into three stages: atypical hyperplasia, carcinoma in situ and early invasive stage;atypical hyperplasia group:PI (91.55), LVA (7570.23), LVD (2.50);carcinoma in situ group: PI (113.36), LVA (12105.45), LVD (3.73);early invasive group: PI (124.67), LVA (14524.33), LVD (5.33). The PI, LVA and LVD were compared among groups above (P<0.05), and the correlation of PI with LVA and LVD was positive (P<0.05);Lymphatic metastasis group:PI (130.50), LVA (15430.67), LVD (6.17), non lymphatic metastasis group:PI (113), LVA (12711.67), LVD (3.67), the PI, LVA and LVD were compared between the two groups above (P<0.05).Conclusion With the development of hamster tongue cancer, lymphatic endothelial cell proliferation activity increased, suggesting that the lymphangiogenesis existed in the tongue carcinogenesis process;the values of the LVD and LVA increased in the hamster tongue cancer development, which was positively correlated with the cancer cell malignance and lymphatic metastasis.

Objective To improve the selection of flying cadets of the Air Force of People′s Liberation Army of China ( PLAAF) by analyzing the differences of medical identification of lumbar spondylolysis between PLAAF and the US Air Force ( USAF) .Methods Flight crew who had been checked for lumbar spondylolysis during hospitalization at the Air Force General Hospital between 2013 and 2015 were chosen.The results of their medical identification were compaired according to PLAAF and USAF Medical Standards Directory, and their differences and possible reasons were analyzed accordingly.Results The qualified rate of PLAAF was about 85%, which was very close to the standards of USAF, but the difference was not of any statistical significance(P>0.05).Conclusion The standards of our medical identification of lumbar spondylolysis was similar to those of USAF, suggesting that the selection of flying cadets can be improved.

Objective To establish the preparation techniques for preparing the reference substance of platycodin-D.Methods Raw material of platycodi radix was extracted with 70 %MeOH.The concentrated extract passed through D101 macroporous resin column,then the 40 %alcohol eluate was separated by silica gel column chromatography with chloroform-methanol gradient elution.The fractions contained platycodin-D were collected and purified by HPLC.Results HPLC analysis and normalization of peak areas showed the purity of the platycodin-D was 98.8 %.Conclusions The preparation techniques are simple and high yield,can be used for preparing the reference substance of platycodin-D.

Exosomes are nanosized membrane microvesicles secreted by various living cells.They contain proteins,lipids,RNA,and a variety of other biological macromolecules.Exosomes play an important role in many pathological and physiological processes,such as antigen presentation in the immune system,repair of damaged tissues,and growth and migration of tumors.Tumor-derived or tumor-associated exosomes play a vital role in regulating the occurrence and development of tumors.The analysis and detection of exosomes in tumors is helpful for the early diagnosis of tumors and provide new treatment methods.This article reviews exosomes' origin,composition,and functions in the development,migration,diagnosis,and treatment of tumors and provides new ideas for the treatment of tumors.

Objective To evaluate the clearance efficacy of resin hemoperfusion(HP) on the removal of organophosphorus in the rabbits poisoned by methamidophos(MAP) and its effects on organ injury. Method Six-teen healthy Japanese white rabbits were randomly divided into HP group and non-HP group. MAP was given through gastric tube in a dosage of 20 mg/kg to rabbits of both groups. Rabbits of liP group received resin hemop-ersion plus conventional treatment including early gastric lavage, atropine and pralidoxime. Rabbits of non-HP group received only conventional treatment. The plasma concentration of MAP was determined by using gas chro-matography before and after rabbits were poisoned at different intervals. Serum choline esterase (ChE),lactic de-hydrogenase (LDH), alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatine kinase (CK) and creatine kinase isoenzyme (CK-MB) of rabbits of both groups were assayed 6 hours after rabbits poisoned. Pathological changes in lung, liver, kidney and muscle were investigated simutaneously. SPSS 10.0 software was used for statistical analysis. The comparison between groups was carried out by using t -test. Results ① The typical symptoms of organophospborus poisoning were occurred in rabbits within 5 - 10 minutes after ingestion of MAP. In HP group, the plasma levels of rabbits before,and 30 min,60 min,90 min and 120 min after hemoperfu-sion were (11.43±1.56),(7.82±1.54),(4.97±1.58),(5.66±1.75) ,(5.49±1.68) μg/mL, respectively (P <0.01). After hemoperfusion, the plasma MAP levels of rabbits in HP group were lower than those in non-HP groups (P < 0.01). The improveme, nt of clinical presentation of rabbits was observed shortly after HP. ② The blood choline esterase activity of rabbits were depressed in hoth groups without significant difference. In contrast, the blood levels of ALT, AST,LDH,CK and CK-MB of rabbits in non-HP group elevated significantly than in HP group (P < 0.01). ③ The more severe injury of muscle, liver, kidnet and lung of rabbits can could be seen in non-HP group. Conclusions ① HP can effectively eliminate the plasma MAP and has the potential to improve the clinical presentation of intoxication in rabbits. ② Early intervention of Hp exerts a protection from organ dam-age of organophosphorus pesticide.